Tag Archives: Eating Disorders

It’s been six months since I embarked on my weight loss and healthier living journey. It’s been going with ups and downs. I lost five kilograms in my first month of attempting to lose weight. Then, I slowly lost more then gained it back. At the end of October, I was at the same weight I’d been at in early July. IN other words, while I had maintained the loss of those first five kilograms, I hadn’t lost any more. Now over the month of November, I lost three kilograms again. I now only need to lose two kilograms to no longer be obese. This means that the goal I set last June, which was to be just plain overweight rather than obese within a year, is still within reach.

One exercise I came across when reading journaling guides for overeaters, is to imagine one day of normal eating. The idea is to imagine what it’d be like to eat normally for a day, then put that plan into actual action. The thing is, even when I was still deep in disordered eating, I usually had a few days of mostly normal eating before I’d down a whole bag of sweets and/or a bag of crisps and/or other unhealthy foods wthin half an hour. For this reason, I’m going to change the exercise a little and create a food plan for a week. Most things I have already implemented, in fact.

Breakfast

I will eat a healthy breakfast each day. This means I’ll eat lower-fat yoghurt with muesli. I used to eat crunchy muesli most days, but I changed that to regular fruit muesli about a month ago. This contains significantly less calories than crunchy muesli, but it does seem to contan somewhat more sugar. Last week, I bought muesli with nuts, which I think I’ll like better than fruit muesli anyway and which is less sugary.

Lunch

I used to eat two slices of bread with peanut butter. Last month, I decided to get sandwich spread instead, which is much lower in calories, although some people tell me it’s not necessarily healthier.

In addition to bread, I started eating a few carrots, tomatoes and cucumber slices for lunch each day. I love to snack on vegetables and particularly the carrots make me feel full too.

Dinner

My husband cooks and serves my food, so I generally trust him to make me relatively healthy meals and limit my portions. Each Friday though, he gets us fries with a snack. When I restarted my weight loss journey a month ago, I thought I’d have to let go of this, but I don’t. Weight loss doesn’t mean never eating any unhealthy food, after all. That’s why I’m pretty wary of Overeaters Anonymous’ idea of abstinence as a goal. I much prefer Eating Disorders Anonymous’ idea of balance.

Snacks

I can have fruit or rice crackers as snacks when I’m home from day activities in the afternoon. During morning coffee at day activities, I should try to turn down the gingerbread, as it’s pretty high in calories and I don’t even like it very much.

On Wednesday, we have a cooking activity at day activities. I love it and am so glad I have been able to fully participate in it, including eating, while still losing weihgt. The staff usually serve it, so they decide on portion sizes.

Every other Friday, my mother-in-law accompanies me to the pharmacy to pick up my medications. I have decided that I can still buy myself something to snack on at the grocery store that’s near the pharmacy, but it needs to be something relatively healthy. For example, the last time, I had chicken bites. Then, I ate them all in one sitting, which I’m not planing on doing tomorrow. I’m still undecided as to whether I can get myself the chicken bites again and hope I’ll restrain myself and leave some for my husband, or whether I should get something else. Here, the goals of abstinence versus balance are competing again.

Drinks

I usually have coffee, tea and water throughout the day. I can have a fizzy drink or juice every once in a while. I should aim for at least two liters of fluids each day. Not even so much for weight loss purposes, but more to prevent getting constipated.

I have often talked about recovery on this blog. Particularly, I have talked about recovery from my disordered eating habits and to a lesser degree self-injury. I wanted to get rid of my binge eating and stop self-injuring. Today, as I gave this some more thought, I took recovery one step further. So what if I stop bingeing and self-injuring? Would that then mean I’d be cured of my mental illness?

Of course, strictly speaking it wouldn’t. However, what if it did? What if I were cured of my mental illnness? After all, I exhibit far fewer destructive and aggressive behaviors than I did years ago. If I were to check mysel finto a mental hospital just as I am now, with no history of acute mental illness, the registrar would laugh at me. I wonder even if I’d be sick enough for outpatient mental health care if I presented with jut the symptoms I’ve been having lately. My overeating may or may not meet the criteria for binge eating disorder or eating disorder NOS. My self-harm does meet the criteria for non-suicidal self-injury, but then again these crteria are quite vague. My mood does not meet the criteria for a disorder. Heck, even when I was suicidal in 2007 and was clearly in need of acute psychiatric care, the only diagnosis the psychiatrist could come up with was adjustment disorder. Adjustment disorder is no longer covered by health insurance. In other words, under DSM-IV, which doesn’t include binge eating or self-injury as diagnoses, I would hardly if at all qualify for psychiatric care.

Of course, I do have borderline personality disorder and Asperger’s Syndrome – I still meet the criteria for these. However, no general practitioner would come up with the idea that I’d have these if I asked them to refer me to mental health services, and the vague referral letter my GP wrote in 2007 would not be enough now. So if I’m not sick enough at first sight for mental health care, am I then recovered? I don’t think so.

Mental health care has in recent years been more and more reduced to mere crisis intervention or other interventions directed at averting people becoming a pain in the neck. Now I won’t say I can’t be a pain in the neck, but a GP writing my referral letter from scratch now would not know. If you aren’t a danger to yourself or others, you most likely won’t get mental health services paid for through insurance. As such, mental health treatment is focused on curing the symptoms of severe mental illness (which is in most cases impossible), whereas recovery is more than that. Recovery, after all, is getting your life back on track.

As a long-term institution patient, I struggle with this. I am relatively well mentally speaking – probably not as well as I describe in the above paragraphs, but still -, but I don’t have a life. When I was admitted to the mental hospital in 2007, I was a university freshman in a new city. Now I’m nearly 30 and have little that could fulfill my life. I have my blog, but that’s about it. It makes me depressed. Not suicidal-type depressed (or should I say “adjustment-disordered”), but it does definitely make me slightly depressed. If I am not sick enough for mental health services and not well enough to get my life back on track without help, then where do I find help in recovering my life?

I hope that outpatient mental health services aren’t really as bad as I now think they are. I can only hope the recovery model still hasn’t been killed by the push for budget cuts. It however makes me sad to read in memoirs of mental health consumers about the recovery model and using mental health services to get your life back on track. After all, I’m afraid you can’t get mental health care for that now even if you’re severely mentally ill like myself.

Welcome to the #AtoZChallenge on mental health, letter E. This is one of the harder letters. However, I still was able to come up with several words for discussion.

Eating Disorders

Eating disorders, which include anorexia, bulimia, binge eating disorder and unspecified eating disorders, are among hte deadliest mental illnesses. This is not just because of the physical effects eating disorders have on their sufferers, but also because people with eating disorders are particularly likely to be suicidal. For clarity’s sake: you can’t tell whether someone has an eating disorder by looking at them, because people of any size can have eating disorders. The core of eating disorders is also often not about what or how much one eats, but about one’s thoughts regarding oneself and one’s eating habits.

Emotions

Emotions are an essential part of human experience. They are often affected by mental illness. An emotion is different from a mood, in that emotions last for a short while whereas moods describe one’s overall affective state over a longer period of time.

Equality

Disabled people, including mentally ill people (yes, mental illness is a disability!), make up the largest minority in the United States and probably elsewhere too. The fight for equality for people with mental illness was started in the 1970s with the antipsychiatry mvement. However, you don’t have to believe that mental illness is a social construct to want equality for mentally ill people nowadays.

Experience

I was inspired to share about experience when someone commented on
another post in the challenge that few mental health professionals have been on the other side of the desk. In the Netherlands, many mental health agencies employ “experience workers”, which are people with a (history of) mental illness who have had additional training in using their experience in the support of other people with a mental illness. Most assertive commnity treatment teams, which are intensive outpatient treatment teams for people with severe mental illness, employ such experience workers. The education of experience workers used to be mostly informal, but now there is even a full college track in social work with mental health experience.

“But whoever listens to me will live in safety and be at ease, without fear of harm.” (Proverbs 1:33 NIV)

I found the above verse in yesterday’s devotion for dieters. Since the verse was taken out of context, I decided to read the entire chapter. Proverbs is in the Old Testament, which to me, who knows very little about the Bible, mostly means it’s based in fear. Before Jesus, people were taught to fear the Lord, and those who did so were seen as wise. That’s also what this chapter seems to say.

However, this particular verse is quite positive. The author of the devotional uses it to make the point that, when we are troubled, we can and should turn to the Lord in prayer.

As I wrote in an old reflection, Jesus himself suffered human temptation. There were, like the author of the devotion for dieters says, also many times when he was persecuted. He didn’t answer in destructive ways, either by attacking the people who persecuted him or by giving in to temptation. Rather, he withdrew and prayed.

The people of the Old Testament may have had a hard time turning to God, because God hadn’t forgiven humanity yet. At least, if I lived in the time of Proverbs 1, I’d not be led to turn to God for guidance that easily, despite what is written in the last verse. However, through Jesus, we can be assured that a loving God will guide us and help us overcome the pressures of life and our human temptation. Jesus knows what it’s like to be under pressure and he also knows what it is like to resist temptation – successfully. By turning to our Lord and Heavenly Father when under stress, he set an example.

Willpower, as I said last month, is the will to turn over the reigns of our life to God. We don’t have to do this thing called life alone.

I have been doing okay’ish in the eating disorder and self-harm departments lately, despite having been under a lot of pressure. In part, this is because I’ve been withdrawing from the pressures of daily life more. That still doesn’t mean I’ve turned myself over to God. I withdraw into ordinary things, like books, writing, pampering myself with body care products, etc. I don’t say this is wrong, but it isn’t doing anything but temporarily distracting me from the pressures of life.

God can help us truly overcome our suffering. He teaches us to pray and, as is written in Proverbs 1:33, listen. If we listen for God’s guidance, we may realize that He will take care of us. I’m not there yet. I’m working on it, praying about it though.

Today, Finish the Sentence Friday’s starter sentence is: “When I look in the mirror, I see…”. Now I could easily respond that I’m blind so I don’t see anything in the mirror. That would however be feeding a common misconception, that is, that blind people don’t have body image issues because they can’t see what they look like in the mirror. Some people even go so far as to assume blind people can’t have eating disorders for this reason. First of all, of course, not all eating disorders are about body image. However, let me tell you, I know several blind people with anorexia, which is in part about body image.

The relationship between my blindness and my body image is however quite complicated. I can’t say there is no relationship, because there is. For example, I gained over 40lbs in the last four years. I know this because people tell me the number on the scale. However, I haven’t tried this but I’m pretty sure that if I had to estimate my size, I would be far off and see myself as far thinner than I am. I do obviously feel my body and I use my hands to measure it. That’s gotten harder as I’ve become bigger, but I don’t notice it as much as someone would by looking in the mirror. I don’t exactly see myself as skinny, in that I know I’m quite fat, but I do often have a hard time reconciling the numbers on the scale with how I feel like I look.

This may seem weird, because I do have a negative image of my body’s shape and size. I hate the fact that I’m fat. When I notice clothing getting tighter, I feel pretty awful about myself. I’ve said that I should weigh half as much as I do now (which would put me in the underweight range). That being said, I play these mind tricks where I allow myself to gain weight despite wanting to lose it. Like, I’ve gotten this insane kind of logic where I’m at a good weight if halving it would put me in the anorexic range. I got it from a Dutch book called something like “How I halved myself and won the battle against anorexia again”.

There are other aspects to body image of course. People who estimate my age by looking at my face, usually think I’m quite a bit older than I am. I can feel the tiny wrinkles on my face, of course, if I really attend to them. That in turn makes them feel a lot larger than my husband says they are – he actually says I don’t have wrinkles at all. However, again, in my mind I still see myself as looking like a teenager.

The last time I had some vision of what I looked like, I was about thirteen. In this light, it makes sense that I am stuck on the image of myself as a teenager. It’s not just my body image though. I still see myself as somewhat like a teenager in many ways. That could be my autistic difficulty adjusting to change applied to myself.

I am a member of a few general recovery groups on Facebook. Most of the members are addicts or alcoholics. I am not. I consider myself addicted to food in some ways, but it isn’t like I can just stop eating, like an addict can quit their substance of abuse. I’m not saying that’s easy either. That’s my point of this post.

Most recovery groups are based on some twelve-step model. As such, we see a lot of references to a higher power or God in the posts. One that I came across recently was that we have to redefine willpower. Willpower is the will to turn over the reigns of our life to God.

I like this statement. It doesn’t mean we don’t have to attempt abstinence (or in the case of an eating disorder, balance). We do still need to refrain from engaging in addictive behaviors. The difference is, God is guiding us on our journeys. If we turn over the reigns of our life to God, we are realizing that we need to follow His lead, not the road of addiction.

I am a person who often turns over the reigns of her life to other people. I allow others to make decisions for me and in some ways, I’d like them to make the decision that I can’t have binge food, too. Staff won’t do this, as I’m an adult and responsible for my own recovery. My husband sometimes gets me a small bag of candy when I’d intended on eating a far larger quantity. This may lessen the physical effects of a binge, but it still means I engage in compulsive eating.

The first step of Overeaters Anonymous is to say we’re powerless over food. (The same statement is used in Alcoholics Anonymous and Narcotics Anonymous, with “alcohol” or “drugs” instead of “food”.) Therefore, we need to find a power greater than ourselves to help us recover from our addiction. Note that this higher power doesn’t necessarily have to be God: for atheists and agnostics, it can be the OA group they participate in. This signifies that, while no-one is taking responsibility for another’s choices, it is the guidance of our higher power, be it God or the group, that leads us into recovery. Even as believers, we believe that we have free will, but we can still turn the reigns of our life over to God. If we do this, we learn to rely on Him for paving the way for us into recovery. It isn’t that we are no longer ourselves in recovery or not, but we rely on God for facilitating our process of recovery.

I am nowhere near recovering, as regular readers of this blog know. My last binge was last Friday, and I was tempted to give in again today. I didn’t, which is a small win, and my thoughts on willpower contributed to that. I realized that God doesn’t want me to binge, and He gives me the means to resist the urge. Today, I was led to write this post instead of binge. It may sound like I don’t practise what I preach, as someone who’s still pretty deep in her eating disorder, but it personally helps me to preach recovery.

A few weeks ago, I was reading Believarexic by J.J. Johnson. Yes, I know I reviewed it already. I didn’t talk about one of the themes in it though, which is competitiveness, perfectionism, narcissism and how these are interrelated. As I just came across a journaling prompt on comparing yourself, I wanted to discuss this now.

I am not a perfectionist. At least, not a successful one. I make a lot of careless mistakes. I also used to send out cards and crafts for swaps that were mediocre at best and worse than a five-year-old could’ve done them at worst. In other words, I am not one to go to great lengths in order to achieve perfection. Of course, my disordered eating is also an example of this. If I attempt to keep control at all, I fail miserably at it. A psychologist who evaluated me when I was eleven, wrote in her report that I lacked self-criticism, in fact.

That being said, I do recognize what Dr. Prakash told Jennifer in the book about being on the head of a pin. If you’re on the head of a pin, you see yourself as great, expect yourself to be great, but once you fail, you hate yourself. I do expect myself to excel or I give up. In this sense, I’ve fallen off my own (and others’) head of a pin so many times that I may look like I don’t care about it anymore. But I do.

I may not show it, but deep down, I’m very sensitive to criticism. Like, I like to think of my English as great, but I definitely know that my pronunciation is an exception to this (and my written English isn’t excelletn either) My husband sometimes jokes, asking “What language is that?” when I speak English. His spoken English isn’t perfect – I’ve never seen his written English -, but it’s better than mine, so I don’t correct him or laugh about it. That being said, knowing that my spoken English is pretty bad, I hardly ever try to use it, so I don’t improve on it. I’d rather stay on my head of a pin and get people I meet online to compliment me on my (written) English.

In some areas, I am competitive and know that I will never win. Like with blogging. I am an okay’ish blogger, but I’ll never be a great blogger, no matter how hard I try. I feel deep down that this is a major weakness of mine, but I blame it on external factors (here comes the lack of self-criticism), or at least uncontrolable ones. For example, I tend to reason that I could be a great blogger if I could use images, which I can’t because I’m blind.

I once read about this type of narcissism called compensatory narcissism. It isn’t an official mental health diagnosis, of course. However, it shows that people with narcissistic traits commonly have low self-esteem. That’s what Dr. Prakash told Jennifer in Believarexic too: that loving yourself too much and hating yourself are sometimes pretty close. Like I said, compensatory narcissism isn’t a formal diagnosis, so I can safely say I fit a lot of the proposed criteria without looking like a hypochondriac, can’t I?

I have published a few posts that were inspired by my reading of the book Believarexic by J.J. Johnson already. I didn’t share many opinions on the book itself though. Early this morning, I finished the book, so I’d like to post a review. This review contains some spoilers.

Synopsis

Fifteen-year-old Jennifer has to force her family to admit she needs help for her eating disorder. But when her parents sign her into the Samuel Tuke Center,
she knows it’s a terrible mistake. The facility’s locked doors, cynical nurses, and punitive rules are a far cry from the peaceful, supportive environment
she’d imagined. In order to be discharged, Jennifer must make her way through the strict treatment program – as well as harrowing accusations, confusing half-truths, and startling insights. She is forced to examine her relationships, both inside and outside the hospital. She must relearn who to trust, and decide for herself
what “healthy” really means.

Punctuated by dark humor, gritty realism, and profound moments of self-discovery, Believarexic is a stereotype-defying exploration of belief and human connection.

Review

This book is an autobiographical novel. The author describes this quite poignantly at the end of the book as “true make-believe”. What this means is that the author did really get inpatient treatment for her eating disorder in 1988 and 1989, but the details and characters may’ve been changed or simplified. I haven’t yet checked the bonus material, so I cannot be sure whether some of the pretty intriguing events in the book did really happen. For instance, one of Jennifer’s fellow patients is signed out by her parents because they don’t believe the program is working. They decide instead to take her to an orthodontist to have her mouth wired shut. Even though this book takes place in the dark ages of the 1980s, I find it hard to believe such a procedure would be legal even then. I do still see the stark contrast between psychiatric treatment then versus now.

Sometimes, I find that characters have been oversimplified in terms of them being either good or bad. Dr. Prakash, Jennifer’s psychiatrist, is nice from the beginning to end, whereas nurse Sheryl aka Ratched is bitchy and controling throughout the book. Still, some characters make quite a transition through the book, and there are incredible twists and turns.

The book starts out a bit triggering with for example the hierarchy of eating disorders being quite extreme. Nonetheless, this book is clearly pro-recovery. At the end of the book, the author encourages people who even have an inkling of an idea that they might have an eating disorder to seek help. As may’ve become clear through some of my previous posts inspired by this book, Belieivarexic led me to some interesting insights.

One day when I was probably in seventh grade, I read an audio magazine for blind teens. It was really a mixture of its own content with content from other teen magazines read aloud. One of the articles from another magazine was about an eating disorders unit. I just remembered this as I read a passage in J.J. Johnson’s Believarexic, in which Jennifer remembers learning about anorexia for the first time in fifth grade and wondering how the celebrity who died of it, got as skinny as she did. Later on, Jennifer learns about people being hospitalized for eating disorders. She envies them because of their size but also because of the attention they get.

This hit home with me. Back in seventh grade, I had already firmly embarked on the binge eating boat, but since I was at a healthy weight for my age and height, I didn’t notice my eating had spiraled out of control already. I remember once, probably in the same year, being confronted by my classmates about getting five candy bars out of the vending machine and eating them all in one sitting. However, I just got annoyed and didn’t realize that my classmates may have wanted to protect me from unhealthful choices.

We didn’t learn about binge eating disorder or compulsive overeating in health class. All we learned about eating disorders was about anorexia and bulimia. I even did one of my gifted program projects on these eating disorders. I didn’t tell anyone that, as I was writing the paper, I was trying to figure out how I could become anorexic.

No, I didn’t “want” anorexia, like some teens say they do. No-one consciously decides to develop an eating disorder. But I did want the perseverance that I perceived anorexics had. So I began keeping food diaries. This was before I had access to the Internet and I couldn’t read packaging, so I couldn’t check calories. In truth, as I look back at my food diaries of the time, they show a pretty typical overeater’s pattern. But I wanted to have some control over my food intake by keeping these diaries. Not that it worked, of course. Over the years, my binge eating got worse.

Back to the article about the eating disorders unit. For some reason, I felt compelled to be like these patients. I don’t know whether it was pure attention-seeking. I mean, I got plenty of attention from my parents and teachers. What I might’ve been missing was someone who saw how much I was struggling. Maybe, if I became anorexic, they’d see how miserable I was.

The other day, I had a meeting with my psychologist. She wa spushing me to take steps towards independence in preparation for my move in with my husband. I can’t remember whether she said so, but she gave me the impression that she felt I was doing better because I had much fewer meltdowns and emotional outbursts. In truth, I may be a little better, but I still have a pretty miserable life and feel pretty crap. Instead of becoming self-destructive or aggressive, I lie in bed or resort to overeating. A fair quality of life is not just not being a pain in the neck, but also being able to experience pleasure every once in a while. It isn’t that I never do, but it’s quite rare that I do things that bring me any sort of satisfaction. For example, I don’t craft nearly as much as I used to, because I can’t handle the noise and crowdedness at day activities.

I was also telling my psychologist that I’m completely dependent on my treatment team. What I meant was close to the exact opposite: I have no control over what goals are set for me, but it is my sole responsibility to reach them.

In a sense, maybe this whole disordered eating thing is a way of showing peope I need help. It sounds so pathetic though: someone who’s nearly thirty-years-old needing to be taken care of like a little child. IN truth though, often I feel that vulnerable.

“Fight” is one of the writing prompts from Mama’s Losin’ It for this week. The first thing that came to mind as I reflect on this word is my fight against my eating disorder tendencies. This fight has been on my mind a lot lately.

Last week, had a bad binge and then in the evening, a fellow patient gave us cake. A nurse was joking about all the calories in the cake, poking my tummy as she asked: “Do you want whipped cream on your cake?” This was extremely triggering to me. At first, I thought “screw you” and decided to indeed get whipped cream on my cake. As time went by and I ruminated on what had happened, the nurse’s words and actions took on a life of their own, causing me to doubt my will to recover from binge eating. Not that I didn’t want to lose weight, but my initial instinct was to move back in the direction of bulimia by starting to purge again.

I later told the nurse that what had happened had been immensely triggering and she assured me that she’d just been fooling around a bit. Usually, this nurse has quite good ideas for helping me recovr from my disordered eating tendencies, so I took no further offense.

This doesn’t mean the doubts about how to fight my obesity have gone. In fact, the only thing holding me back from starting to purge again is my chronic heartburn, for which I’m getting an upper GI endoscopy done to see what might be wrong. I don’t have that long of a history of purging, but that doesn’t mean that the purging I did do can’t have caused damage. It certainly won’t get better if I resort back to purging now.

However, eating disorders are not just about preserving one’s health. After all, they often do the exact opposite. There is this hierarchy in eating disorders where restrictive anorexics rank as most perseverant and stubborn, followed by binge/purge anorexics, bulimics depending on their weight and the biggest losers (no pun intended) are the compulsive overeaters. In other words, as someone who suffers from binge eating only, I’m a total failure of an eating disorder sufferer. Yet I am not just an eating disorder sufferer, I am a person who happens to have disordered eating tendencies and who wants to fight these tendencies.

This hierarchy of the eating disordered is, however, also reflected in how seriously I take myself and am taken by other people with regard to my disordered eating tendencies. When I still purged, my GP put in my file that I had bulimia. I didn’t – bulimia has very strict criteria that I didn’t meet -, but it was in my records nonetheless. Now that I probably do meet the criteria of binge eating disorder, I’m commonly seen as just a little overweight at best and as an unmotivated, lazy fatass at worst. It’s probably crazy that I’d rather be seen as sick than lazy.